title: Team clinician variability in return-to-play decisions.
abstract: OBJECTIVE
  To describe the variability in the return-to-play (RTP) decisions of experienced team clinicians and to assess their clinical opinion as to the relevance of 19 factors described in a RTP decision-making model.
  
  
  METHODS
  Survey questionnaire.
  
  
  METHODS
  Advanced Team Physician Course.
  
  
  METHODS
  Sixty-seven of 101 sports medicine clinicians completed the questionnaire.
  
  
  METHODS
  Results were analyzed using descriptive statistics. For categorical variables, we report percentage and frequency. For continuous variables, we report mean (SD) if data were approximately normally distributed and frequencies for clinically relevant categories for skewed data.
  
  
  RESULTS
  The average number of years of clinical sports medicine experience was 13.6 (9.8). Of the 62 clinicians who responded fully, 35% (n = 22) would "clear" (vs "not clear") an athlete to participate in sport even if the risk of an acute reinjury or long-term sequelae is increased. When respondents were given 6 different RTP options rather than binary choices, there were increased discrepancies across some injury risk scenarios. For example, 8.1% to 16.1% of respondents who chose to clear an athlete when presented with binary choices, later chose to "not clear" an athlete when given 6 graded RTP options. The respondents often considered factors of potential importance to athletes as nonimportant to the RTP decision process if risk of reinjury was unaffected (range, n = 4 [10%] to n = 19 [45%]).
  
  
  CONCLUSIONS
  There is a high degree of variability in how different clinicians weight the different factors related to RTP decision making. More precise definitions decrease but do not eliminate this variability.
authors.affiliation: *Department of Orthopaedic Surgery, Human Performance Laboratory, Stanford University School of Medicine, Palo Alto, California; †Division of Sports Medicine, Department of Orthopaedic Surgery, Stanford University School of Medicine, Palo Alto, California; ‡Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Quebec, Canada; and §Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Shultz
authors.forename: Jennifer
authors.initials: J
authors.lastname: Bido
authors.forename: Ian
authors.initials: I
authors.lastname: Shrier
authors.forename: Willem H
authors.initials: WH
authors.lastname: Meeuwisse
authors.forename: Daniel
authors.initials: D
authors.lastname: Garza
authors.forename: Gordon O
authors.initials: GO
authors.lastname: Matheson
mesh_terms: D000465:Algorithms; D001265:Athletic Injuries / Q000534:rehabilitation*; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013178:Sports Medicine / Q000592:standards* / Q000706:statistics & numerical data